Co-Occurring Basics
What does "co-occurring conditions" mean?
When a person has two or more mental health or medical conditions at the same time.
How can a counselor tell if a client’s difficulty focusing is due to ADHD or anxiety?
ADHD inattention occurs in all situations; anxiety-related inattention is tied to worry.
Why do PTSD and substance use disorders often co-occur?
People with PTSD may use substances to cope with trauma-related distress.
Name one symptom that can appear in both depression and anxiety.
Fatigue, Sleep disturbances, Difficulty concentrating, Restlessness, and Irritability.
What is an integrated treatment plan?
A plan that treats both conditions together rather than separately.
True or False: Co-occurring disorders always have the same symptoms.
False! Symptoms can overlap but may also be very different.
How might ADHD symptoms increase feelings of anxiety?
Disorganization, missed deadlines, and difficulty completing tasks can create stress and increase anxiety.
Name one symptom that both PTSD and substance use disorder share.
Sleep disturbances, emotional dysregulation, or difficulty concentrating.
Why is it important to distinguish between depression and an anxiety disorder?
Treatment approaches may differ—some therapies or medications work better for one than the other.
Name one challenge of using medication to treat co-occurring disorders.
Some medications may help one condition but worsen another (e.g., stimulants for ADHD increasing anxiety).
Why is it important to diagnose both conditions in a co-occurring disorder?
Treating only one may leave the other untreated, affecting progress.
Why might someone with ADHD feel overwhelmed even when starting simple tasks?
Difficulty prioritizing and regulating attention can make small tasks feel too big to start.
What is one risk of ignoring substance use when treating PTSD?
The client may continue using substances to manage PTSD symptoms, making treatment less effective.
What is one way a counselor can consider if excessive worry is due to depression or an anxiety disorder?
In anxiety disorders, worry is typically future-focused, involving excessive fear about potential outcomes. In depression, rumination is more past-focused, centered on feelings of regret, hopelessness, or perceived failures.
How does cultural background affect the diagnosis of co-occurring conditions?
Cultural stigma may prevent people from seeking treatment, and symptoms may be expressed differently across cultures.
What can happen if only one disorder in a co-occurring diagnosis is treated?
The untreated condition may continue to cause symptoms, relapse, or make the treated condition worse.
What makes treating ADHD and anxiety together challenging?
Stimulants for ADHD can increase anxiety, while anxiety treatments may not address focus and impulsivity.
How does trauma impact the brain in a way that increases addiction risk?
Trauma changes stress responses, increasing impulsivity and emotional dysregulation, leading to self-medication.
What is a common misdiagnosis when someone has both depression and anxiety?
Major Depressive Disorder alone—counselors may overlook anxiety symptoms.
Why is reassessing a client’s diagnosis over time important when treating co-occurring disorders?
Symptoms can change, one condition may improve while another worsens, or new issues may emerge.
What are two common challenges in diagnosing co-occurring conditions?
Symptom overlap makes diagnosis difficult, and one condition may mask the other.
A client reports difficulty focusing, racing thoughts, and excessive worry. What information would help a counselor decide if it’s ADHD, anxiety, or both?
History of symptoms (frequency), if inattention happens in all settings (duration), and whether worry is the main trigger for focus issues (impact).
What type of treatment is most effective for clients with both PTSD and substance use disorder?
Integrated treatment that addresses both trauma and substance use together (e.g., trauma-focused therapy + addiction recovery).
A client with depression and anxiety struggles to complete daily tasks. What treatment approaches can help both disorders?
CBT for coping skills, behavioral activation, and mindfulness techniques.
A client is diagnosed with ADHD, but later reports trauma symptoms. What should a counselor do before assuming ADHD is the primary diagnosis?
Assess for PTSD or other trauma-related conditions, as trauma can mimic ADHD symptoms.